严重胸部钝性损伤后血浆PGI_(2)、TXA_(2)的变化及意义  

The significance of thromboxane A2 and prostacyclin in plasma after severe chest trauma

作　　者：刘达兴[1] 牛义民[1] 刘日辉[1] 周继红[2] 

机构地区：[1]遵义医学院附属医院胸心外科,贵州遵义563003 [2]第三军医大学大坪医院野战外科研究所,重庆400042

出　　处：《遵义医学院学报》2007年第3期259-262,共4页Journal of Zunyi Medical University

基　　金：贵州省"十五"社会发展攻关课题[黔科合农社字(2001)1132号]

摘　　要：目的探讨胸部钝性损伤后血浆PGI2、TXA2的变化规律,为临床救治胸部钝性损伤提供实验依据。方法利用BIM-Ⅱ型生物撞击机制备兔严重胸部钝性损伤模型;并用杏丁注射液干预血浆PGI2、TXA2的变化作为对照。分别于撞击前5min、撞击后5min、30min、2h、4h、8h、24h采颈总动脉血检测血栓素A(2TXA2)、前列环素(PGI2)的含量;于伤后24h摘取心脏作光镜检查,随机取2只兔心作电镜检查,观察心肌组织形态学改变。结果血浆PGI2浓度在伤后早期(伤后4小时)明显下降,而血浆TXA2浓度则明显升高。形态学检查心肌组织损伤较重。用杏丁注射液提高血浆PGI2浓度、降低TXA2浓度后心肌组织损伤则明显减轻。结论严重胸部钝性损伤后早期(4小时以前)血浆PGI2下降和TXA2升高可能会加重其合并的心肌挫伤。Objective To explore the changes and significance of thromboxane A2 and prostacyclin in plasma after severe chest trauma in rabbits. Methods 30 rabbits were randomly divided into three groups：control group with false-impact （control group, n=10）, severe chest trauma group （MC group, n=10） and xingding injection treated group （XDI group, n=10）. The model of rabbit severe chest trauma were produced by the BIM-Ⅱ Horizontal Bioimpact Machine. At 5th minute before impact and 5th minute,30th minute,2th,4th,Sth,24th hour after impact, rabbits blood in each group was taken from common carotid artery to measure the concentrations of plasma thromboxane A2 （TXA2） and prostacyclin （PGI2） by Radioimmunoprecipitation. At the end of experiment each rabbit heart in each group were observed the micro-structure changes and 2 hearts were randomly taken from each group to observe ultra-structure changes. Results The concentrations of plasma PGI2 had a distinct falling-off while the contents of plasma TXA2 significantly higher in the early period of severe chest trauma （at 4 hour after chest trauma）. The morphological injures of myocardial tissures were severe. With xingding injection, the reduction of the concentrations of plasma PGI2 and the increase of the contents of plasma TXA2 were lower. The morphological injures of myocardial tissures were lighter than those of MC group. Conclusions The myocardial contusion might be aggravated by reduction of the concentrations of plasma PGI2 and the increase of the contents of plasma TXA2 in the early period of severe chest trauma.

关 键 词：胸部钝性伤 PGI2 TXA2 心脏挫伤 

分 类 号：R645[医药卫生—外科学]